508 MEDICAL JURISPRUDENCE Occasionally the toxic symptoms may not appear immediately after the intravenous administration of the drug, but may "be delayed for some weeks and death may occur from acute yellow atrophy of the liver. Policard and Pinard u cite a case of syphilis in a man, aged 28 years, who, fifty days after three doses equivalent to 1.05 gramme of neosalvarsan, developed acute yellow atrophy of the liver and died in six days. Fatal Dose and Fatal Period.—According to Holland15 10.5 grammes of salvarsan might cause death. Medicinal doses have, however, caused death. A dose of 0.5 gramme of salvarsan injected intravenously caused the death of a Kashmiri Mahomedan, aged 20 years, in 25 hours.10 A woman, 42 years old, suffering from Addison's disease, died in 12 hours after an intravenous injection of 0.15 gramme of neosalvarsan.17 A male, aged 50 years, who was suffering from asthma, died within half an hour of receiving an intravenous injection of 0.6 gramme of neosalvarsan.18 Treatment.—Inject adrenaline hydrochloride hypodermically before or after the injection to ward off the symptoms of an anaphylactic nature. Give intravenous or rectal injections of normal saline as well as hyper tonic solutions of sodium chloride and sodium bicarbonate to render the blood alkaline and to eliminate arsenic from the system. Inject intravenously sodium thiosulphate in doses of 0.45, 0.6 and 0,9 gramme dissolved in 5 cc. of water on alternate days and 25 ml. of a 25 per cent solution of dextrose on each of the intervening days for the treatment of exfoliative dermatitis. Give also liver extract and ascorbic acid. Administer intravenously 25 to 50 ml. of a 25 per cent solution of glucose for the treatment of jaundice. Inject intravenously 10 cc. of a 5 per cent solution of sodium deKydrocholate mixed with neosalvarsan to combat its toxic action on the liver. B.A.L. has been recently recommended in the treatment of dermatitis and other complications arising in the course of arseno-therapy. Two millili- tres of a solution containing 10 per cent B.A.L. and 20 per cent benzyl benzoate in arachis oil should be injected intramuscularly into the thigh or gluteal region. Post-mortem Appearances.—Cloudy swelling or fatty degeneration of the liver, kidneys and heart may be present. Acute encephalitis with haemorrhagic spots in the brain may be found. Chemical Tests.—1. Ammonio-nitrate of silver produces a yellow preci- pitate of arsenite of silver in an arsenious acid solution. 2. Ammonio-sulphate of copper gives a bright green precipitate of arsenite of copper (Scheele's green). 3. Reinsch's Test.—This is a very delicate test,, and arseniq, may be readily detected to the extent of 1 : 1,000,000 and 1 : 7,000,000 if the solution is concentrated. The method of procedure is as follows: — Drop one or two strips of bright copper foil into the suspected solution previously acidulated with pure hydrochloric acid and boil it for five to ten minutes, when the copper foil is coated steel-grey or black with a deposit of arsenic, if present. The foil is then removed, washed successively in distilled water, alcohol and ether, dried on filter paper and then heated by placing it in a small test tube. The deposit, if due to arsenic, volatilizes and forms a white deposit further up in the cooler portions of the tube. This deposit, 14. Presse Medicate, Jan. 8, 1921, p. 42 ; Peterson, Haines and Webster, Leg. Med. and Toxic., VoL n, Ed. H, p. 258. 15. Med. Cherrt. and Toxic., p. 288. 16. Neve, Ind. Med. Gaz.t Jan. 1915, p. 20. 17. Hellfors, Medizinische Klinik, Berlin, Jan. 20, 1933, p. 117; Jour. Amer. Med. Assoc., March 18, 1933, p. 860. 18. C. C. Mahadeva, Ind. Med. Gaz., Feb. 1943, p. 126.